FILMING PERMIT APPLICATION FORM
If you wish to film on public space within Golden Plains Shire, you should first call Council’s Community Events Officer on 03 5220 7111 to discuss your requirements, and to see if you are required to complete this form.
APPLICANT INFORMATION
COMPANY DETAILS
Company/Applicant Name(responsible for the filming):
Does thecompany name match the name insured on the public liability insurance (PLI)?
(Please note: A permit will not be issued without current PLI)
If NO: Please provide more information
CONTACT DETAILS
Name
Position/Title
Phone
On-site contact on day of filming:
Name
Position/Title
Phone
PRODUCTION INFORMATION
Project name
Production type – circle appropriate:
For OTHER, please specify
Proposed filming date/s?
From: To:
Alternative filming dates(weather hold/contingency planning)
From: To:
Filming times (including bump-in and bump-out times)?
LOCATION INFORMATION
Exact location/s of the proposed filming?(Including any privately owned land.):
(If there’s more than one location add another location at the end of this section.)
Please provide a brief summary or synopsis of the scene and/or activities:
Number of people on location?
Number of cast
Number of crew
Number of parking spaces required at the filming location
Numberof cars
Numberof trucks
Number of oversize vehicles (over 7.5 m long or over 4.5 tonnes)
(Please include relevant details in the Parking Application Attachments section below)
Will the production need a unit base?
If YES: Please add your unit base to your site plan/mud map to the attachments at the end of this document
Exact location/s of the proposed unit base?(Including any privately owned land.)
Unit base times (start/finish)?
How many parking spaces required at the unit base?
Number of cars
Number of trucks
Will the production erect any temporary structures such as tents or marquees at the unit base?
If YES: Please provide details of these temporary structures (size, number, style)
(Please note:temporary structures need to be secured by weights, not pegs or stakes)
Will the production requiretrafficmanagement or pedestrian management?
(Please note: If the production is disrupting traffic or pedestrian flow a Traffic Management Plan (TMP) or Pedestrian Management Plan (PMP) Incorporating a Risk Management Plan will be required).
Type of activity (e.g.hold & release, road closure)
Name and details of the traffic/safety company who will be supplying the TMP or PMP?
What times will the roads be affected?
Start of closure
Finish of closure
Name of the roads affected by the closure/traffic hold?
Details of any large equipment the production will bring to the location
(E.g. camera cranes, scaffolding, lighting towers.)
Please indicate [Y] if the production will involve any of the following.
☐firearms/weapons (including imitation)*☐amplified music or sound
☐other safety concerns*☐ stunts*
☐may have environmental impact☐may cause offense or concern to the public
*Confirmation of approval from Victoria Police or other state government agencies will be required with this application.
Provide details of activity:
ATTACHMENTS
Please include the relevant documentation for your production. If the documentation is unavailable to be sent at this time please indicate the date on which it will be sent.
Essential documentation:
Public liability insurance: Proof of certificate of currency ($10 - $20M cover)
Site plan/mud maps:
Identifies Parking, Traffic control, unit base, where crew are situated and any equipment other than the normal amount of filming equipment required for the shoot e.g cranes, long dolly, boom lifts, scissor lifts.
A site plan must be included with your application.
Risk management plan or safety plan
Identifies any risks associated with your filming activity and methods you will employ to minimise / eliminate these risks. May be included as part of a traffic management or pedestrian management plan, or other activities that involve risk you need to manage, e.g. trip hazards, explosives.
Optional documentation:
If you’re unsure which of the following documentation you need to attach, contact us to discuss.
Running Sheet/Schedule:
A document which establishes a chronology, linking times, events and details of filming activities.
Stakeholder communication plan (Public notification letter)
The purpose of this is to give traders, residents and other interested parties timely written notice in advance of your proposed filming activities and show how you’ll address their concerns.
Traffic & Pedestrianmanagement plan(s)
Required if traffic will be slowed, blocked, redirected, or perhaps even distracted. Be certain to check if you need permits from Victoria Police and VicRoads (attach your copies of their permits in the ‘Other permits, approvals etc’ section at the end of this form).
Other permits, approvalsor filming information (running sheets, schedules)
Any other permits or approvals we have asked you for. For example Victoria Police, VicRoads, Parks Victoria, a waste management plan, etc.
Victorian Screen Industry Code of Conduct
We agree to abide bythe Victorian Screen Industry Code of Conduct.
Please return completed filming permit application form, along with attachments to:
Filming Enquiry
Executive Unit
Golden Plains Shire Council
PO Box 111
Bannockburn Vic 3331
Email:
Fax: 03 5220 7100
Golden Plains Shire Council Filming Permit Application Form 2018 PAGE 1